<%@page contentType="text/html" pageEncoding="UTF-8"%>
<!DOCTYPE html>
<html>
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
        <title>Contact Us</title>
        <link href="/Digipao/media/css/bootstrap.css" rel="stylesheet" type="text/css"/>
        <link href="/Digipao/media/css/bootstrap-theme.min.css" rel="stylesheet" type="text/css"/>
        <link href="/Digipao/media/css/bootstrap.min.css" rel="stylesheet" type="text/css"/>
        <link href="/Digipao/media/css/backgroud-digipao.css" rel="stylesheet" type="text/css"/>
    </head>
    <body>
        <div id="fundo-externo">
            <div id="fundo">
                <img src="/Digipao/media/images/zoom-bg-1.jpg" alt=""/>
            </div>
        </div>

        <div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 text-center margin-top-20">
            <h1 class="templatemo-site-title">
                <img src="/Digipao/media/images/digipao100714-2115100714-2117.png" alt=""/>
                <h2>Contate-nos</h2>    
            </h1>
        </div>

        <div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 margin-top-20">
            <div class="container-fluid container panel panel-default">
                <table class="table table-hover table-striped">        
                    <tr>
                        <td><label for="nome">Nome</label></td>
                        <td><input id="nome" class="form-horizontal" placeholder="Nome"></input></td>
                    </tr>

                    <tr>
                        <td><label>Endereço</label></td>
                        <td><input id="endereco" class="form-horizontal" placeholder="Endereço"></input></td>
                    </tr>

                    <tr>
                        <td><label>Nº</label></td>
                        <td><input id="numero" class="form-horizontal" placeholder="00"></input></td>
                    </tr>

                    <tr>
                        <td><label>CEP</label></td>
                        <td><input id="cep" class="form-horizontal" placeholder="_____-___"></input></td>
                    </tr>

                    <tr>
                        <td><label>Cidade</label></td>
                        <td><input id="cidade" class="form-horizontal" placeholder="Cidade"></input></td>
                    </tr>

                    <tr>
                        <td><label>UF</label></td>
                        <td>
                            <select id="ddl" class="dropdown-header">
                                <option value="0">AC</option> 
                                <option value="1">SP</option> 
                                <option value="2">RJ</option> 
                                <option value="3">CE</option> 
                            </select>
                        </td>
                    </tr>
                    <tr>
                        <td><label>Telefone</label></td>
                        <td>
                            <input id="telefone" type="text" class="form-horizontal" placeholder="()   -    "></input>
                        </td>
                    </tr>
                    <tr>
                        <td><label>Observações</label></td>
                        <td>
                            <textarea id="observacao" type="text" class="form-horizontal" placeholder="Observações"></textarea>
                        </td>
                    </tr>
                </table>

                <div class="text-right">
                    <button class="btn-success" type="submit">Enviar</button>
                    <button class="btn-danger" type="submit" onClick="parent.location='/Digipao/index.html'">Cancelar</button>
                </div>
            </div>
        </div>
    </body>
</html>
